NPIMap

Organization Active NPI

Laboratorio Clinico Y de Ref de Fajardo Inc

Doing business as Laboratorio del Este

  • Clinical Medical Laboratory
  • Fajardo, PR
National Provider Identifier
1689724866
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
670 Issued in PR
Legal business name
LABORATORIO CLINICO Y DE REF DE FAJARDO INC
Doing business as
Laboratorio del Este
Practice address
General Valero Ave 303
Fajardo, PR 00738
Phone
(787) 863-3000
Fax
(787) 860-5700
NPI assigned
Jan 11, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Sara Lopez, MDNPI 1003931726
Title
Pathologist (Director)
Phone
(787) 863-3000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 670 PR Primary

Addresses

Primary practice location

General Valero Ave 303
Fajardo, PR 00738

Mailing address

General Valero Ave 303
Fajardo, PR 00738
Phone (787) 863-3000

Other names 1

  • LABORATORIO DEL ESTE Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071112000003 PR Part B Supplier - Independent Clinical Laboratory 7911095856 2 other NPIs on this enrollment
Practice locations: Fajardo, PR; Vieques, PR; Ceiba, PR

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Laboratorio Clinico Y de Referencia de Fajardo Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1689724866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "GENERAL VALERO AVE 303",
            "city": "FAJARDO",
            "state": "PR",
            "postal_code": "00738",
            "telephone_number": "787-863-3000",
            "fax_number": "787-860-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "GENERAL VALERO AVE 303",
            "city": "FAJARDO",
            "state": "PR",
            "postal_code": "00738",
            "telephone_number": "787-863-3000",
            "fax_number": "787-860-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LABORATORIO CLINICO Y DE REF DE FAJARDO INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LOPEZ",
        "authorized_official_first_name": "SARA",
        "authorized_official_title_or_position": "PATHOLOGIST (DIRECTOR)",
        "authorized_official_telephone_number": "787-863-3000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "PR",
            "license": "670",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LABORATORIO DEL ESTE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fajardo, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.